News - NGSMEDICARE

Posting Date: 09/09/2024

Psychotherapy Services and Targeted Probe and Educate

Psychotherapy Services and Targeted Probe and Educate We’ve added a new section to our website for Psychotherapy Services. Visit this page for informative instruction about completing a psychotherapy ...

Posting Date: 09/06/2024

LCD and Article Updates for August/September 2024

LCD and Article Updates for August/September 2024 Local Coverage Determinations Facet Joint Interventions for Pain Management L35936 Effective 8/1/2024 - Updated "Coverage Indications, Limitations and...

Posting Date: 09/05/2024

MLN Connects® Newsletter: September 5, 2024

MLN Connects® Newsletter: September 5, 2024 News Osteogenesis Stimulators: Prior Authorization Requirements Suspended Hospice Benefit: Expanding Prepayment Review in 4 States Skilled Nursing Facility ...

Posting Date: 08/29/2024

MLN Connects® Newsletter: August 29, 2024

MLN Connects® Newsletter: August 29, 2024 News CMS Roundup (August 23, 2024) Physicians, Teaching Hospitals, & Non-Physician Practitioners: Review Your Open Payment Data by December 31 Claims, Pricers...

Posting Date: 08/22/2024

MLN Connects® Newsletter: August 22, 2024

MLN Connects® Newsletter: August 22, 2024 News Commemorating the 2nd Anniversary of the Lower Cost Prescription Drug Law MolDx Local Coverage Determination Statement Hospital Price Transparency: Get R...

Posting Date: 08/20/2024

Electronically Submitted Claims that Exceed $99,999.99 Reminder

Electronically Submitted Claims that Exceed $99,999.99 Reminder Electronically submitted claims containing a dollar amount in excess of 99,999.99 will be rejected as a front-end EDI edit. The Standard...

Posting Date: 08/15/2024

Additional Development Requests for Part A Claims for CPT J9299

Additional Development Requests for Part A Claims for CPT J9299 A system error on 7/25/2024 caused ADR letters to be issued in error on Part A claims for CPT J9299 with DOS on or after 3/1/2024. The i...

Posting Date: 08/15/2024

MLN Connects® Newsletter: August 15, 2024

MLN Connects® Newsletter: August 15, 2024 News Negotiating for Lower Drug Prices Works, Saves Billions Resources & Flexibilities to Assist with the Public Health Emergency in Florida, Georgia, and Sou...

Posting Date: 08/08/2024

MLN Connects® Newsletter: August 8, 2024

MLN Connects® Newsletter: August 8, 2024 Final Payment Rule Hospital Inpatient Prospective Payment System & Long-Term Care Hospital Prospective Payment System FY 2025 Final Rule News Transitional Cove...

Posting Date: 08/08/2024

Supplemental Security Income Ratio Realignment for Cost Reporting Periods Starting Before 10/1/2013

Supplemental Security Income Ratio Realignment for Cost Reporting Periods Starting Before 10/1/2013 On 6/9/2023, in response to the Supreme Court’s ruling in Azar v. Allina Health Services, 139 S. Ct....

Posting Date: 08/07/2024

Unnecessary Adjustments for Part B Claims

Unnecessary Adjustments for Part B Claims A recent transition process at the Medicare Part B system maintainer has resulted in unnecessary and inappropriate Part B claim adjustments, impacting all MAC...

Posting Date: 08/05/2024

Telehealth Place of Service 02 and 10 Clarification

Telehealth Place of Service 02 and 10 Clarification National Government Services has been receiving inquiries from providers in regard to POS 02 and POS 10 for telehealth service reporting. We’ve crea...

Posting Date: 08/02/2024

Introducing the All-New Medicare University!

Introducing the All-New Medicare University! We encourage you to visit the new Medicare University and explore these exciting enhancements. Simply follow the directions below to check it out. Loggin...

Posting Date: 08/01/2024

MLN Connects® Newsletter: August 1, 2024

MLN Connects® Newsletter: August 1, 2024 Final Payment Rules Skilled Nursing Facility FY 2025 Final Rule Inpatient Rehabilitation Facility FY 2025 Final Rule Inpatient Psychiatric Facility FY 2025 Fin...

Posting Date: 07/31/2024

CLIA Number Processing Issue

CLIA Number Processing Issue National Government Services has been made aware of an issue with CLIA lab claims processing. CLIA numbers were not loaded through CWF, resulting in claim denials as CLIA ...

Posting Date: 07/29/2024

LCD and Article Updates for August 2024

LCD and Article Updates for August 2024 Articles L33394/A52423 – Drugs and Biologicals Provided off-label coverage of Infliximab for microscopic colitis and retirement of Bortezomib article, effective...

Posting Date: 07/25/2024

MLN Connects® Newsletter: July 25, 2024

MLN Connects® Newsletter: July 25, 2024 News CMS Announces Resources & Flexibilities to Assist with Public Health Emergency in Texas CMS Oral Health Cross-Cutting Initiative Fact Sheet Doctors & Clini...

Posting Date: 07/25/2024

National Government Services Will Send Email Updates from a New Email Address Beginning 8/7/2024

National Government Services Will Send Email Updates from a New Email Address Beginning 8/7/2024 Starting 8/7/2024, National Government Services will send email updates to you from a new email address...

Posting Date: 07/24/2024

Health Benefits of Quitting Smoking and Helping Your Patients Kick the Habit

Health Benefits of Quitting Smoking and Helping Your Patients Kick the Habit Smoking leads to multiple diseases and potentially death, but it is preventable! Anyone at any age can benefit from quittin...

Posting Date: 07/23/2024

Frequently Asked Questions Have Been Reviewed and Updated

Frequently Asked Questions Have Been Reviewed and Updated We’ve reviewed and updated our educational FAQs. Visit our Help and FAQs page located within the Education section of our website. Please take...

Posting Date: 07/22/2024

Frequently Asked Questions Have Been Reviewed and Updated

Frequently Asked Questions Have Been Reviewed and Updated We’ve reviewed and updated our educational FAQs. Visit our Help and FAQs page located within the Education section of our website. Topics avai...

Posting Date: 07/18/2024

A/B DME MAC Collaborative Webinar: Positive Airway Pressure Devices

A/B DME MAC Collaborative Webinar: Positive Airway Pressure Devices Physicians/Practitioners! Are you Ordering PAP Devices for Your Patients? This is your opportunity to hear directly from the Medicar...

Posting Date: 07/18/2024

MLN Connects® Newsletter: July 18, 2024

MLN Connects® Newsletter: July 18, 2024 News Final Part Two Guidance to Help People with Medicare Prescription Drug Coverage Manage Prescription Drug Costs Medicare Ground Ambulance Data Collection Sy...

Posting Date: 07/18/2024

“Payer Only” Codes Submitted on Part A Medicare Claims

“Payer Only” Codes Submitted on Part A Medicare Claims This article is to inform Part A providers of an editing change impacting claims submitted with “payer only” codes. As of 7/3/2024, new edits cau...

Posting Date: 07/17/2024

Top Claim Errors Reviewed and Updated

Top Claim Errors Reviewed and Updated Using data analysis, we review and update the Top Claim Errors on a quarterly basis and provide: the error reason code; a description of the error; the error type...

Posting Date: 07/16/2024

Hospice Quality Reporting Letters

Hospice Quality Reporting Letters CMS notified MACs of hospice providers that either chose not to participate in the Hospice QRP or failed to meet the Hospice QRP reporting requirements for the data c...

Posting Date: 07/11/2024

MLN Connects® Newsletter: July 11, 2024

MLN Connects® Newsletter: July 11, 2024 Proposed Rules Physician Fee Schedule CY 2025 Proposed Rule Hospital Outpatient Prospective Payment System & Ambulatory Surgical Center Payment System CY 2025 P...

Posting Date: 07/11/2024

Part B Top Claim Errors Updated

Part B Top Claim Errors Updated Using data analysis, we update the Top Claim Errors on a quarterly basis and provide: the error reason code; a description of the error; the error type; details that in...

Posting Date: 07/03/2024

MLN Connects® Newsletter: July 3, 2024

MLN Connects Newsletter: July 3, 2024 News ESRD Prospective Payment System CY 2025 Proposed Rule — Submit Comments by August 26 CMS Roundup (June 28, 2024) Improve Your Search Results for CMS Content ...

Posting Date: 07/01/2024

2024 CMS Health Equity Services

2024 CMS Health Equity Services The 2024 Physician Fee Schedule Final Rule expanded Medicare coverage by adding four services to the Medicare program for coverage. These services are to help further a...